Back Pain? Quit Smoking Now

Smoking cessation lowered pain for spinal disorder patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Nicotine doesn’t help pain—it actually makes it worse. Patients with spinal disorders, who quit smoking during treatment, reported less back pain after quitting.

A recent study assessed back pain levels of 5,333 spinal disorder patients. Results were then compared to each patient’s smoking history. Researchers found a link between nicotine and back pain.

“We know that nicotine increases pain. In this study, if you quit smoking during treatment, you got better. If you continued to smoke, there was statistically no improvement, regardless of the treatment you had,” said the lead author.

"Call 1-800-QUIT-NOW."

Glenn R. Rechtine, MD, from the Department of Orthopaedics at the University of Rochester Medical Center in New York, worked with a team to investigate the link between smoking and back pain. For the study, 5,333 patients with axial (mechanical) or radicular (nerve) pain from a spinal disorder were evaluated for pain levels for eight months and smoking history.

Patients were evaluated for smoking history and placed into four groups:

  • Smokers (914)
  • Quit smoking during treatment (253)
  • Former smokers (1,532 quit before treatment began)
  • Never smokers (2,634)

Patients were asked to complete the visual analogue scale (VAS) to rank their pain at the beginning of the study and at each follow-up. The VAS measured pain in four categories: worst, least, weekly and current.

Only 3 percent of the group had spinal surgery.

Study results showed that patients which had a decrease of more than 30 percent of the “worst” pain was experienced by:

  • 31 percent of never smokers
  • 29 percent of former smokers
  • 17 percent of current smokers
  • 32 percent of quit smokers

This shows that patients who quit smoking during treatment were most likely to have significant reduction in severe back pain at 32 percent.

Current smokers experienced the least amount of severe back pain reduction at 17 percent.

A total of 22 percent of smoking patients quit during this trial.

Dr. Rechtine said, “Smoking is bad for you. Basically, the likelihood to improve your care—surgical or non-surgical—was dramatically decreased if you are a smoker.” “

“This study supports the need for smoking cessation programs for patients with a painful spinal disorder given a strong association between improved patient reported pain and smoking cessation.”

Authors recommended incorporating smoking cessation programs into treatment of painful spinal disorders.

This study was published in December in The Journal of Bone & Joint Surgery.

Funding was supported by a grant from the Southwestern Medical Foundation.

No conflicts of interest were reported.

Reviewed by: 
Review Date: 
December 10, 2012
Last Updated:
February 15, 2013